Do You Need Help With That?

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Could managing our insulin levels reduce the worst symptoms of perimenopause? So muses endocrinologist Gillian Goddard in her newsletter, The Savvy Patient, writing that she is increasingly “delving into patients’ metabolic health before they have any obvious signs of disease,” as there are benefits for addressing changes in blood sugar metabolism early.

It’s fascinating, but not surprising, that more and more evidence links higher fasted insulin to how women experience perimenopause — specifically hot flashes. Who knows what other, less obviously perimenopausal, suffering could also be connected. More research is needed.

Speaking of interesting areas of research: We were blown away by health and science writer Julia Belluz’s new feature on GLP-1s this week. In a behind-the-scenes newsletter, Belluz says she her assumptions before the piece were completely upended by what she actually found after reporting it out. Such as how, “more than 60 percent [of survey respondents] said that if their GLP-1 failed to help the condition it was initially prescribed to treat, they would keep taking it for other benefits.” Doctors absolutely do not know what to make of all this. (“I’ve never come across another medical story where scientists repeatedly apologize for how bewildering their results appear to be.”)

As we’ve learned from all the features we’ve published about estrogen and midlife, hormones are systemic, meaning they affect basically everything. As Belluz writes, “GLP-1 receptors are found all over the body, and when people receive much higher, longer-lasting doses than humans produce naturally, a wide range of benefits surface.” We saw someone refer to this class of drugs as “weight-health hormone replacement therapy” which…makes sense!

This week’s feature is all about a new cottage industry we’ve seen cropping up: menopause coaching. What is it, what does it cost, and why are women turning to this (probably the aforementioned suffering)? Read on for that, plus a few recommendations for your weekend.

Bye,
Your friends at Gloria

When I first heard the term "menopause coach" on the show Bad Sisters, I didn't know if it was real or a joke. What would a menopause coach do and who would hire one? 

It turns out that menopause coaches are real, and what they do runs the gamut. Like any other kind of coaching, they work with clients in an ongoing relationship toward a desired outcome. Most coaches are not clinical, but in rare cases, they can be doctors. Most do not accept insurance. Costs vary, but roughly speaking you can expect to pay around $100 per hour, which likely includes some amount of messaging with your coach. A menopause coach with a medical degree might charge twice as much, but what's included (prescriptions, follow-ups, etc.) will also vary. 

The most common problems menopause coaches address are weight gain, hot flashes, and lack of sleep, though I learned they tend to take a holistic approach, so instead of dealing with issues in isolation, they address your overall quality of life and mindset to find ways to live happier, healthier, and more comfortably. A lot of coaches have already reached menopause, and since they've been there, they can take on a mentorship role, too.

Midi and Re-spin are two big menopause wellness businesses that you may have heard of. Both offer coaching, although they aggressively market the prescription and supplement side of the business. Among smaller providers, you can find menopause coaches with expertise in certain areas, such as those who help gender non-conforming people or who've had additional training in sexual health. 

Dr. Tes Jordens, D.O., runs a telehealth practice called 1988 Wellness. She's one of the rare medical professionals who is a menopause coach. She doesn't love the term "coach," but the subscription model ($1,079 for six months) she offers women in the throes of perimenopause and menopause does resemble a coach-like relationship.

Generally speaking, Jordens' patients are women from age 40 to 65, "but we know that perimenopause can start much earlier, especially if a woman has had surgical menopause, so there certainly isn't any cutoff," she said.

When I asked what she does as a menopause coach, she said, "Basically, I'm here as a guide and to support women through this time period." As a physician, she has one big advantage over others: "I can prescribe, and often that's what women are coming to see me for, or that's the main thing," she said. 

A woman's primary care physician, whether it's a GP or a GYN, can also write prescriptions, but they don't necessarily make themselves available for follow-up appointments and ongoing support the way Jordens does.

"My big thing is there isn't any pill, shot, patch, cream, gel, spray — it doesn't matter what it is — none of that is going to help with all of the things" related to menopause, Jordens said. "It's everything we do, from our brain and our mindset to what we're doing with our physical bodies." 

One of Jordens' patients recently told her that she chose her for menopause care because the flood of information online was overwhelming, and she wanted one trustworthy person who could make recommendations tailored specifically to her. As a physician, Jordens can offer that.

When choosing a menopause coach, the most important factor is determining whether you need one with a medical background. Several coaches I spoke to mentioned that anyone with a history of cancer treatment probably needs an MD or a DO. It doesn't mean they can't work with a nonmedical coach, but the coach might insist that they have ongoing medical guidance in addition. Another consideration is whether you want a coach who has training in a particular area, whether it's nutrition, physical fitness, sex, or something else.

Comfort is in, and we’re here for it. Our favorite new source for wear-’em-all-day basics? Pact, which sells earth-friendly options made of 100% organic, sustainable cotton. This set, available in a ton of good colors, is an amazing deal at under $100. These cotton leggings are great if you’re over synthetics (which we are trying to replace in our workout wardrobes). And these perfect, throw-on easy pants will be in heavy rotation this spring and summer.

They’re having a big sale for Earth Month – and you can also take 20% off with GLORIA20. Take a look, and shop it all, here. #partner

TO WATCH Want to feel old? Netflix’s funny new series about college roommate drama (titled Roommates) stars Adam Sandler’s daughter. Also on Netflix: The second season of Beef, which is essentially an entirely new show with a new cast (Oscar Isaac and Carey Mulligan as a middle-aged couple in a bad marriage). Two indie films in theaters we’re also contemplating: The Christophers, starring Michaela Coel, and Mile End Kicks, which is kinda like Almost Famous for millennials.

TO TRY This doctor-recommended vibrator is designed to help you rekindle intimacy. Its bendable shape stimulates multiple pleasure zones to intensify arousal and natural lubrication. Discover new sensations or bring more orgasms into partnered moments. Get 50% off – no code necessary. #partner

TO LISTEN After hearing indie musician Jenn Wasner’s single “Afraid” on the radio a few times while driving, we finally were able to track down the rest of the album. We’re really into it. If you like Sharon Van Etten, this might be up your alley, too.

TO MAKE We finally tried this viral frozen dumpling recipe, and it was excellent: comforting, tasty, and fast. Let your dumplings defrost in the fridge the night before — it’ll help when baking.

Menopause in prison: confusing, scary, “Kafkaesque.” • Some interesting takeaways in this look at cannabis use, brain health, and age. • A really helpful overview on retinol. • Is it a true “baby bust,” or are women just waiting longer to have children? (Or both?) • Checks out: “Elon Musk’s artificial intelligence software, Grok, continues to generate sexualized images of people without their consent.”

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